Panayiotis Glavas' letter highlights a weakness we discussed in both of our articles.1,2 We too were disappointed in our inability to include Quebec medical schools. We relied on Canadian Federation of Medical Students (CFMS) representatives to publicize the study at each site; because the 3 francophone schools are not CFMS members, we had little control of how the survey was promoted in Quebec. Gathering email addresses for all Quebec students proved to be an unachievable goal. In fact, we were told by the Sherbrooke representative of the Fédération des associations étudiantes en médecine du Québec (FAEMQ) that many students still do not use email. Glavas also comments that we could have “easily eliminated [premedical student] responses from the final analysis if [we] wished to do so.” Without resurveying the Quebec students, separating premedical and medical students would have been impossible.
We agree that our results are applicable only outside Quebec. There are several reasons (e.g., lower tuition fees, different admissions requirements) why Quebec medical students may be different from those elsewhere in Canada. In the end, we had no choice but to reluctantly exclude the Quebec data from our main analyses. However, we have made the data available to the FAEMQ and are willing to share the data more widely if others are interested.
The 2 letters by Sarah Giles and Clare Bastedo and colleagues eloquently describe the personal financial hardships faced by many medical students. Both letters question the adequacy of existing financial support programs. We agree that government loan maximums have not kept pace with tuition increases and hope that the findings of our study lead to reviews of existing programs by which medical students receive support.
Irfan Dhalla Vice-President, Education Canadian Federation of Medical Students Toronto, Ont. Jeff Kwong Community Medicine Resident University of Toronto Toronto, Ont. Ian Johnson Associate Professor Department of Public Health Sciences Faculty of Medicine University of Toronto Toronto, Ont.
References
- 1.Kwong JC, Dhalla IA, Streiner DL, Baddour RE, Waddell AE, Johnson IL. Effects of rising tuition fees on medical school class composition and financial outlook. CMAJ 2002;166(8):1023-8. [PMC free article] [PubMed]
- 2.Dhalla IA, Kwong JC, Streiner DL, Baddour RE, Waddell AE, Johnson IL. Characteristics of first-year students in Canadian medical schools. CMAJ 2002;166(8):1029-35. [PMC free article] [PubMed]